Provider Demographics
NPI:1740574185
Name:BULL-HUERTA, CHERI LORRAINE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:LORRAINE
Last Name:BULL-HUERTA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 COVERED VLG
Mailing Address - Street 2:
Mailing Address - City:BELDING
Mailing Address - State:MI
Mailing Address - Zip Code:48809-1600
Mailing Address - Country:US
Mailing Address - Phone:616-794-2290
Mailing Address - Fax:888-871-0219
Practice Address - Street 1:240 COVERED VLG
Practice Address - Street 2:
Practice Address - City:BELDING
Practice Address - State:MI
Practice Address - Zip Code:48809-1600
Practice Address - Country:US
Practice Address - Phone:616-794-2290
Practice Address - Fax:888-871-0219
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302029276183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302029276OtherSTATE OF MICHIGAN